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The Ideal Candidate for Biologic Therapy: Would Biologics Help Your Psoriasis?

Not everyone qualifies for this new treatment option.

Biologic therapy can be a life-changing option for people with severe psoriasis symptoms that have not responded to other treatment options. Biologics can yield results in just a month (or up to 12 weeks).

Psoriasis is an autoimmune condition that causes the immune system to attack the body’s skin cells, and biologics work by targeting the specific part of the immune system that is overreacting. (Learn more about how biologics treat psoriasis here.)

Psoriasis Severity

Like with many other health conditions, treatment for psoriasis can range from mild to more aggressive. Doctors always aim to find the mildest treatment option that yields effective results, in order to prevent unnecessary side effects.

People with mild psoriasis can often treat their skin symptoms with lifestyle changes to reduce inflammation, healthy skin care habits, and topical steroids. If these treatments are not enough, however, biologics may be considered.

“Biologics are currently approved for patients suffering from moderate to severe psoriasis,” says Bobby Buka, MD, dermatologist and section chief at Mount Sinai School of Medicine.

There are a number of factors that can determine whether someone has mild, moderate, or severe psoriasis, so the ideal candidates for biologics don’t always express the exact same symptoms.

Emotional Impact

If someone is experiencing a high emotional toll from psoriasis, their diagnosis may be considered moderate to severe even if their symptoms are not affecting a large portion of their body. This person may be a good candidate for biologic therapy.

For example: “You can have 10 percent of the body surface area involved with not much psycho-social impact, or you can have really severe dandruff that’s only five percent of the body’s surface area, but has a really depressive, emotional effect on a patient,” says Dr. Buka. The former may have more surface area involved, but the latter is experiencing greater quality-of-life impact.

Local vs. Systemic Treatment

Sometimes, psoriasis is localized to a single part of the body; other times, plaques may appear in numerous locations around the body.

If you only have one affected part of the body, it’s easy enough to treat it with a cream or ointment. “For patients [who] have psoriasis that involve multiple body parts, a cream or ointment may not make sense. That I think is an ideal candidate for biologic therapy,” says Dr. Buka.

Other Health Risks

Biologics only shut down a specific part of the immune system, which for the most part allows the body to continue to defend against most viral and bacterial infections.

Biologics are not recommended for patients who already have a compromised immune system, according to the National Psoriasis Foundation. Blood tests are required before starting a biologic.

Tuberculosis testing is also necessary. The same part of the immune system that creates psoriasis symptoms also helps protect against tuberculosis, according to Dr. Buka. “We want to make absolutely sure that before we start a biologic, these patients have not been exposed to tuberculosis,” he says.

Curious about how treatment with biologics works? Check out the treatment process for biologic therapy here.

Bobby Buka, MD

This video features information from Bobby Buka, MD. Dr. Buka is a section chief at Mount Sinai School of Medicine. Dr. Buka is also a diplomate of the American Board of Dermatology and the Society for Pediatric Dermatology.

Duration: 2:48. Last Updated On: May 24, 2019, 2:10 p.m.
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